In physical therapy terms, a patient's “chest” is comprised of the skeletal and muscular structures of the upper torso, particularly including the ribcage and spine and the muscles attached to them. In addition to large chest muscles such as the pectoralis, the chest includes small muscles and muscle fibers that aid in breathing, posture, and upper-body motor skills. Collectively, these muscles are referred to as the accessory muscles. The accessory muscles may include the scalene muscles, the sternocleidomastoid muscle, the levatores costarum, the intercostals and subcostals, the transversus thoracis, the serratus posterior superior, and the serratus posterior inferior. The accessory muscles may be compromised by injury, invasive medical procedures, malnutrition, sedentary lifestyle, genetic disposition, or developmental delays that may have been caused as early as the patient's infancy.
A lack of accessory muscle strength or development may lead to health and physical developmental problems ranging from bothersome to very serious. These include bad posture, diminished respiratory capacity and support, speech problems due to lack of breath suspension, increased susceptibility to injury, low agility and athletic performance, undesirable physical appearance, and decreased motor function, particularly in the arms as they would otherwise be supported by the core muscles. Additionally, when the ribcage is not properly supported by the accessory muscles, the application of unequal forces over time may lead to flared ribs and pectus excavatum, also known as sunken chest. A device and therapy method is needed to address the habilitation and rehabilitation of underdeveloped or injured accessory muscles.
In a particular example, recently a link has been shown between underdevelopment of the patient's accessory muscles and a shortage of time the patient spent lying on his stomach during infancy, commonly referred to as “tummy time.” During tummy time, an infant's chest works against the resistance of the infant's own weight in order to draw breath into the lungs. This activates the chest muscles associated with breathing and essentially trains the infant to breathe with the chest muscles rather than the stomach muscles alone. This effect is a widely unrecognized benefit of tummy time, which is primarily thought to strengthen the neck and back muscles while the infant learns to hold up and control his head.
It follows that when infants do not get enough tummy time, the chest muscles fail to develop. Historically, 6-12 hours per day of tummy time has been recommended, much of which may be achieved while the infant sleeps. Unfortunately, infants that sleep on their stomachs appear to be more susceptible to sudden infant death syndrome, so parents and caregivers have largely curtailed unsupervised tummy time. Additionally, tummy time may be challenging for infants who have medical problems, such as a compromised respiratory system or gastroesophageal reflux disease. It would be advantageous to provide the developmental benefits of tummy time without the associated dangers to an infant.
Physical therapists currently present intensive, session-based therapy regimens to improve core stability. Most commonly, these regimens include several exercises using a stability ball. Other balance, posture, and lifting exercises using the stability ball may be incorporated to train the core muscles. These regimens are often effective for adults and older children. However, they require continued visits to the therapist several times a week, can be physically intensive, only focus on the larger muscles of the patient's core, and are only developing the muscles at the time of the session. Furthermore, due to the physical exertion and impact of the exercises, these regimens are not appropriate for infants and young children. A program that passively develops the accessory muscles with a minimal interruption to the daily routine of the patient and can be used for patients of all ages is needed.
Some devices for correcting posture are known. Typically, these are some form of brace that provides passive support to the spine. However, these devices do not train accessory muscles, and therefore could not be used to address the problems defined above. Furthermore, these devices are generally for adults and are not often usable for infants or young children. A device that passively trains the chest muscles associated with breathing and posture, specifically the accessory muscles, and can be used for patients of all ages is needed.
Therefore, it is an object of this invention to provide a method and device for developing or rehabilitating the accessory muscles of the upper torso. It is a further object that the method and device be usable by infants, children, and adults. It is a further object that the method and device passively provide a positive developmental effect on a daily basis. It is another object of the invention to provide a method and device that implements a therapeutic regimen to address breathing, speech, posture, and motor skill deficiencies caused by injury to or underdevelopment of the accessory muscles of the upper torso.